Abstract
This paper investigates the structure of psychopathological symptoms. Based on AMDP symptom profiles, a symptom space was calculated by robust nonmetric multidimensional scaling (NMDS) and the symptom structures of a sample dating from 1980 and a sample from 2002/2003 were compared. The method of NMDS presented in this study allows results from other studies to be confirmed and complemented. The symptom factors identified in the past by factor-analytic studies were replicated as clusters in two-dimensional symptom maps. Additionally, some theoretically assumed clusters of symptoms were detected that were not found in previous factor analysis approaches. From the results, which are depicted in a continuous space, new insights can be gained, especially with regard to questions of categorical and dimensional classifications. The comparison of the structural aspects of the symptomatology across more than two decades resulted in only small divergences and allows conclusions to be drawn about the stability of these structures and consequently of the symptom clusters and dimensions.
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References
Angst J, Scharfetter C, Stassen HH (1983) Classification of schizo-affective patients by multidimensional scaling and cluster analysis. Psychiatria Clin 16:254–264
Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie (1981) Das AMDP-system. Manual zur Dokumentation psychiatrischer Befunde. Springer, Berlin
Baumann U, Stieglitz RD (1983) Testmanual zum AMDP-system. Empirische Studien zur Psychopathologie. Springer, Berlin
Baumann U, Stieglitz RD (1997) Das AMDP-system: ein psychologischer test? In: Haug H-J, Stieglitz RD (eds) Das AMDP-system in der klinischen Anwendung und Forschung. Hogrefe, Göttingen, pp 30–45
Berner P (1983) Diagnostic classification based on the AMDP-system. In: Bobon D, Baumann U, Angst J, Helmchen H, Hippius H (eds) The AMDP-system in pharmacopsychiatry. Karger, Basel, pp 68–73
Borg I, Groenen P (2005) Modern multidimensional scaling—theory and applications, 2nd edn. Springer, New York
Bottlender R, Strauss A, Möller HJ (2000) Prevalence and background factors of depression in first admitted schizophrenic patients. Acta Psychiatr Scand 101:153–160
Cattell RB (1966) The scree test for the number of factors. Multivar Behav Res 1:245–276
Cuesta MJ, Peralta V (2001) Integrating psychopathological dimensions in functional psychoses: a hierarchical approach. Schizophr Res 52(3):215–229
Cuesta MJ, Peralta V, Gil P, Artamendi M (2003) Psychopathological dimensions in first-episode psychoses. From the trunk to the branches and leaves. Eur Arch Psychiatry Clin Neurosci 253:73–79
Cuesta MJ, Peralta V, Zarzuela A (2000) Reappraising insight in psychosis. Multi-scale longitudinal study. Br J Psychiatry 177:233–240
De Boeck P, Wilson M, Acton GS (2005) A conceptual and psychometric framework for distinguishing categories and dimensions. Psychol Rev 112(1):129–158
Dilling H, Mombour W, Schmidt MH (2000) Internationale Klassifikation psychischer Störungen ICD-10 Kapitel V(F) Klinisch-diagnostische Leitlinien. World Health Organization, Geneva
Egli S, Läge D (2007) Selektion eines Proximitätsmaßes für einen klinischen AMDP-Datensatz. Forschungsberichte aus der Angewandten Kognitionspsychologie: Universität Zürich, Psychologisches Institut. Report no.: 48
Egli S, Riedel M, Möller HJ, Strauss A, Läge D (2009) Creating a map of psychiatric patients based on psychopathological symptom profiles. Eur Arch Psychiatry Clin Neurosci 259:164–171
Egli S, Schlatter K, Streule R, Läge D (2006) A structure-based expert model of the ICD-10 mental disorders. Psychopathology 39:1–9
Egli S, Streule R, Läge D (2008) The structure-based expert model of the mental disorders—a validation study. Psychopathology 41:286–293
Freyberger HJ, Schulte-Markwort E, Dilling H (1993) Referenztabellen der WHO zum Kapitel V(F) der 10. Revision der Internationalen Klassifikation der Krankheiten (ICD-10): ICD-10 vs. ICD-9. Fortschr Neurol Psychiatr 61:128–143
Gebhardt R, Pietzcker A, Strauss A, Stoeckel M, Langer C, Freudenthal K (1983) Skalenbildung im AMDP-system. Arch Psychiatr Nervenkr 233:223–245
Gower JC, Legendre P (1986) Metric and Euclidean properties of dissimilarity coefficients. J Classif 3:5–48
Guy GW, Ban TA (1982) The AMDP system. Manual for the assessment and documentation of psychopathology. Springer, Berlin
Haug HJ, Ahrens B (2002) Affektive Störungen. In Freyberger HJ, Schneider W, Stieglitz R-D (Hrsg) Kompendium Psychiatrie, Psychotherapie, psychosomatische Medizin. Karger, Basel, pp 100–118
Hurley JR, Cattell RB (1962) The Procrustes program: producing direct rotation to test a hypothesized factor structure. Behav Sci 7:258–262
Jäger M, Bottlender R, Strauss A, Möller HJ (2004) Fifteen-year follow-up of ICD-10 schizoaffective disorders compared with schizophrenia and affective disorders. Acta Psychiatr Scand 109(1):30–37
Jaspers K (1913, 1997) General psychopathology. Johns Hopkins University Press, Baltimore
Kraemer HC, Noda A, O’Hara R (2004) Categorical versus dimensional approaches to diagnosis: methodological challenges. J Psychiatr Res 38:17–25
Kruger G, Haubitz I (1980) Classification of organic brain syndromes by cluster analysis. Arch Psychiatr Nervenkr 228:299–315
Kruskal JB, Wish M (1978) Multidimensional scaling. Sage, Beverly Hills
Läge D, Daub S, Bosia L, Jäger C, Ryf S (2005) Die Behandlung ausreißerbehafteter Datensätze in der Nonmetrischen Multidimensionalen Skalierung—Relevanz, Problemanalyse und Lösungsvorschlag. Forschungsberichte aus der Angewandten Kognitionspsychologie: Universität Zürich, Psychologisches Institut. Report no.: 21
Läge D, Egli S, Riedel M, Möller HJ (2011) Combining the categorical and the dimensional perspective in a diagnostic map of psychotic disorders. Eur Arch Psychiatry Clin Neurosci 261:3–10
Lauterbach E, Rumpf HJ, Ahrens B, Haug HJ, Schaub R, Schonell H, Stieglitz RD, Hohagen F (2005) Assessing dimensional and categorical aspects of depression: validation of the AMDP Depression Scale. Eur Arch Psychiatry Clin Neurosci 255:15–19
Lee JH, Jang MK, Lee JY, Kim SM, Kim KH, Park JY, Lee JH, Kim HY, Yoo JY (2005) Clinical predictors for delirium tremens in alcohol dependence. J Gastroenterol Hepatol 20:1833–1837
Möller H-J (2005) Allgemeine Psychopathologie. In Möller H-J, Laux G, Deister A (Hrsg) Psychiatrie und Psychotherapie. Thieme, Stuttgart, pp 40–71
Möller H-J (2005) Problems associated with the classification and diagnosis of psychiatric disorders. World J Biol Psychiatry 6:45–56
Pickles A, Angold A (2003) Natural categories or fundamental dimensions: on carving nature at the joints and the rearticulation of psychopathology. Dev Psychopathol 15:529–551
Pietzcker A, Gebhardt R, Strauss A, Stöckel M, Langer C, Freudenthal K (1983) The syndrome scales in the AMDP-system. In: Bobon D, Baumann U, Angst J, Helmchen H, Hippius H (eds) The AMDP-system in pharmacopsychiatry. Karger, Basel, pp 88–99
Salvatore P, Khalsa HMK, Hennen J, Tohen M, Yurgelun-Todd D, Casolari F, DePanfilis C, Maggini C, Baldessarini RJ (2007) Psychopathology factors in first-episode affective and non-affective psychotic disorders. J Psychiatr Res 41:724–736
Sato T, Bottlender R, Kleindienst N, Möller HJ (2002) Syndromes and phenomenological subtypes underlying acute mania: a factor analytic study of 576 manic patients. Am J Psychiatry 159(6):968–974
Sato T, Bottlender R, Kleindienst N, Möller HJ (2005) Irritable psychomotor elation in depressed inpatients: a factor validation of mixed depression. J Affect Disord 84:187–196
Schneider K (1959) Clinical psychopathology. Grune and Stratton, New York
Stieglitz RD, Freyberger HJ, Mombour W (2002) Klassifikation und diagnostischer Prozess. In: Freyberger HJ, Schneider W, Stieglitz R-D (Hrsg) Kompendium Psychiatrie, Psychotherapie, psychosomatische Medizin. Karger, Basel, pp 17–31
Sulz KD, Gigerenzer G (1982) Psychiatrische diagnose und nosologische Theorie: Untersuchungen zum individuellen Diagnoseschema des Arztes. Arch Psychiatr Nervenkr 232:39–51
Thien-Seitz U (2006) Bevölkerungsbäume für München im historischen Vergleich. Münchner Statistik 3:19–21
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This study was supported by a grant from the Swiss National Science Foundation (fellowship, project no. 117011).
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Läge, D., Egli, S., Riedel, M. et al. Exploring the structure of psychopathological symptoms: a re-analysis of AMDP data by robust nonmetric multidimensional scaling. Eur Arch Psychiatry Clin Neurosci 262, 227–238 (2012). https://doi.org/10.1007/s00406-011-0271-x
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DOI: https://doi.org/10.1007/s00406-011-0271-x